血管性认知功能障碍脑血流灌注的临床研究

›› 2012, Vol. 7 ›› Issue (04): 284-289.

血管性认知功能障碍脑血流灌注的临床研究

高薇薇1，薛蓉2，程焱2

1天津市中医药研究院附属医院ICU2天津医科大学总医院神经内科

收稿日期:2010-10-25 修回日期:2010-09-25 出版日期:2012-04-20 发布日期:2012-04-20
通讯作者: 薛蓉

Clinical Study about Cerebral Blood Perfusion of Vascular Cognitive Impairment

GAO Wei-Wei, XUE Rong, CHENG Yan

Received:2010-10-25 Revised:2010-09-25 Online:2012-04-20 Published:2012-04-20
Contact: XUE Rong

摘要/Abstract

摘要： 目的探讨血管性认知功能障碍（vascular cognitive impairment，VCI）脑血流灌注的早期表现，分析局部脑血流量（regional cerebral blood flow，rCBF）的减低与认知受损领域的关系。方法将入组患者按照认知受损程度分为：认知正常组、非痴呆血管性认知功能障碍（vascular cognitive impairment not dementia，VCIND）组及血管性痴呆（vascular dementia，VaD）组。分析比较三组患者不同区域rCBF的差异，及各区域rCBF与蒙特利尔认知评分（Montreal Cognitive Assessment，MoCA）相关性；分析比较血流灌注显像与形态学显像的差异；分析rCBF与各认知受损领域的关系。结果三组患者左侧颞叶、左丘脑、左侧海马局部脑血流量差异有显著性（F=8.232、6.237、6.136；P=0.002、0.006、0.000）。左侧颞叶、丘脑及海马rCBF与MoCA评分具有相关性（P=0.011、0.023、0.029）且为正性相关（r=0.421、0.355、0.323）。SPECT检查下出现rCBF减低的平均区域数多于头部磁共振检查下出现梗死灶的平均区域数，但二者差异无显著性。左侧顶叶rCBF与计算力相关，且呈正相关性（Beta=0.445，P=0.020）；右侧海马、右侧颞叶与时间地点定向力相关，且为正相关（Beta=0.626、0.740；P=0.035、0.023）。结论 SPECT检查下显示rCBF的变化为VCI是以颞叶、海马、丘脑低血流代谢为主要表现提供了病理生理学依据。SPECT检查下显示rCBF的变化有早于脑组织结构检查下形态结构变化的趋势。

关键词: 血管性认知功能障碍; 脑血流量; 单电子发射断层扫描

Abstract: Objective To investigate the significance of diagnose in vascular cognitive impairment(VCI) with single photon emission computed tomography. To analyze the relationship with decrease of regional cerebral blood perfusion and the specified domain of cognitive impairment.Methods The patients were collected from either the ward or clinic in Tianjin general hospital from April 2009 till April 2010. We divided all the patients into 3 groups according to the level of their cognition. The 3 groups are the control group, the vascular cognitive impairment not dementia(VCIND) group and the vascular dementia(VaD) group. We compared the change of regional cerebral blood flow(rCBF) in each area of cerebrum within 3 groups and analyzed the relationship with decrease of regional cerebral blood perfusion and score of the Montreal cognitive assessment(MoCA). We compared the difference of perfusion image and morphological image and analyzed the relationship with decrease of regional cerebral blood flow and the specified domain of cognitive impairment.Results The rCBF of the left temporal lobe, thalamus and hippocampus of VaD and VCIND is lower than the control group. There is difference in statistics among these 3 groups(F=8.232, 6.237, 6.136; P=0.002, 0.006, 0.000). The rCBF of the left temporal lobe, thalamus and hippocampus has positive collection with the score of MoCA through the spearman analysis(r=0.421、0.355、0.323; P=0.011, 0.023, 0.029). The rCBF of the left temporal lobe has the positive relationship in the domain of calculation(Beta=0.445, P=0.020), and the rCBF of the right temporal lobe and hippocampus have the positive relationship in the domain of orientation(Beta=0.626, 0.740, P=0.035, 0.023).Conclusion The low rCBF in the temporal lobe, thalamus and hippocampus supply the evidence to the conclusion that the performance in pathology of VCI is low perfusion of the temporal lobe, thalamus and hippocampus. The change in perfusion may have the tendency of performing earlier than the change in morphology.

Key words: Vascular cognitive impairment; Cerebral blood flow; Single emission computed tomography

高薇薇;薛蓉;程焱. 血管性认知功能障碍脑血流灌注的临床研究[J]. , 2012, 7(04): 284-289.

GAO Wei-Wei;XUE Rong;CHENG Yan. Clinical Study about Cerebral Blood Perfusion of Vascular Cognitive Impairment [J]. , 2012, 7(04): 284-289.

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